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J Thorac Cardiovasc Surg 2001;122:569-577
© 2001 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease (ACD)

Comparison of survival after mitral valve replacement with biologic and mechanical valves in 1139 patients

From the Department of Surgery, Duke University Medical Center, Durham, NC.

This study was funded in part by grants from St Jude Medical, Inc, and Baxter Healthcare Corp.

Received for publication May 5, 2000. Revisions requested Sept 6, 2000; revisions received Dec 5, 2000. Accepted for publication Feb 28, 2001. Address for reprints: Donald D. Glower, MD, Box 3851, DUMC, Durham, NC 27710.

Abstract

Objective: We sought to compare 10-year survival in patients after mitral valve replacement with biologic or mechanical valve prostheses.
Methods: Retrospective survival analysis was performed on data from 1139 consecutive patients older than 18 years of age undergoing mitral valve replacement with Carpentier-Edwards (n = 495; Baxter Healthcare Corp, Irvine, Calif) or St Jude Medical (n = 644; St Jude Medical, Inc, St Paul, Minn) prostheses.
Results: The 10-year survival was not statistically different between the patients receiving Carpentier-Edwards valves and those receiving St Jude Medical valves (P = .16). Adjusted survival estimates at 2, 5, and 10 years were 82% ± 2% (95% confidence intervals, 79%-85%), 69% ± 2% (95% confidence intervals, 64%-73%), and 42% ± 3% (95% confidence intervals, 37%-48%), respectively, for the Carpentier-Edwards group and 83% ± 2% (95% confidence intervals, 80%-86%), 72% ± 2% (95% confidence intervals, 69%-76%), and 51% ± 3% (95% confidence intervals, 45%-58%), respectively, for the St Jude Medical group. Predictors of worse survival after mitral valve replacement are older age, lower ejection fraction, presence of class IV congestive heart failure, coronary artery disease, renal disease, smoking history, hypertension, concurrent other valve surgery, and redo heart surgery.
Conclusion: Choice of biologic or mechanical prosthesis does not significantly affect long-term patient survival after mitral valve replacement.

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